For the last two weeks (ending March 6), Texas saw the largest percentage drop in hospitalizations since the pandemic began.  Fatalities are also trending down but that data was badly skewed by reporting delays from the winter storm.  Overall, it was an incredibly encouraging two weeks.

Hospitalizations

Hospitalizations and ICU bed usage dropped by 35% during the last two weeks, dropping to below 5,000 for the first time since October 24.  Hospitalizations have fallen by nearly two-thirds since their peak on January 12.

The daily percentage decline is holding steady at about 2.5%.  If that continues, Texas will drop below the September lows in about two weeks.

All of Texas’ 22 reporting regions saw decreases over the last two weeks.  The largest decline was in Dallas where the numbers had gotten quite high.  Houston and San Antonio also saw substantial drops.  According to SETRAC, COVID hospitalizations in the Houston region are now 11.5% of all hospitalizations, the lowest level since early December.

Fatalities

As expected, there was a significant backlog of fatalities that were not reported during the winter storm that artificially lowered the numbers for that week and makes the fatality data very difficult to interpret.  Probably the best indication is that the current seven-day rolling average for reported fatalities is 233, which compares to a little over 300 a month ago.

The state’s actual date of death analysis, which compensates for the reporting delays, continues to raise the fatality toll in mid-January.  January 13 is now showing as the worst day of the pandemic at 369 deaths.  But it is also indicating we are on the backside of a very steep decline in the fatalities.  

We are probably currently in the 100-150 range for actual daily fatalities.  If hospitalizations continue fall at their current pace, that number is going to come down fast.  The latest run of the IHME model is projecting that we are currently at 135 fatalities per day but will be under 10 by the end of June.

Vaccines

The vaccination of Texans continues to move forward at a steady pace.  Despite all the media hand wringing over how badly Texas is doing, the CDC website shows that 10.7% of the over-18 population has been fully vaccinated.  That compares to a national average of 11.7%.  California and New York are also at 10.7%, but I see very little media hand wringing over how the rollout is going in those two states.

Texas continues to be handicapped by getting one of the lowest per capita allocations from the federal government.  As of Saturday, Texas was ranked 42^nd on a per capita basis of the over-18 population.  I find it incredibly frustrating that our members of Congress are too busy hurling infectives at each other to see that Texas gets its fair share of the vaccines.  But it appears we are going to be flooded with vaccines within a matter of weeks, even at the current rate.  Several counties, including Galveston County, are now taking reservations for any person over 18.  So, the vaccination numbers should continue to rise rapidly.

Testing Results

I continue to be completely baffled by Texas testing data.  According to the State’s data, testing has dropped to about 50-60,000 per day, which is about half of the number we were doing just two weeks ago.  The calculated positivity rate for the two-week period was 13.8%.  That is over three times the national average for the same period and cannot possibly be correct.  The State’s positivity rate based on the date of specimen continues to  drop but was still at 8.9% at the end of the two weeks.  The 7-day rolling average of “new cases” has dropped 75% since early January.  I cannot make heads or tails of this data and include it only to make a complete report to you.

Conclusion

Most of the attention in Texas over the last two weeks has been speculation about what effect Governor Abbott’s loosening restrictions will have.  The issue that got the most attention was the elimination of the mask mandate.  The masking issue has become absurdly politicized with both sides grossly overstating their cases.  If there is anyone out there that does not already have an obdurate opinion on the subject, this FactCheck.org article is the best summary I have seen about what we know and do not know about the efficacy of masks.

I would have preferred phasing in the rollback instead doing it all at once, but I do think it was time to start the process.  My guess is that Abbott’s order will not have much effect.  The IHME model has parameters for masks and for reopening at a faster pace.  It predicts that universal masking would make about a 1% difference and a faster reopening of about 10%.  Those variances are well within the historic error of that model, indicating they are having a limited statistical impact on the model’s calculations.

Concern about the variants continues to be somewhat muddled.  We still know very little about their actual effect on transmission or whether they increase the risk of serious disease.  In the U.K and South Africa, home to two of the variants, cases and fatalities have been rapidly falling.  In Brazil, home to the third variant that people worry about, the outbreak is continuing at a higher level.  There have been some stories that the British variant is driving a new outbreak in northern Italy.  But frankly the data is so sketchy no one really knows what effect they are having.  I keep coming back to the fact that viruses have been mutating during epidemics for millennia but none of their epidemics have yet escaped the inexorable mechanics of herd immunity.

The CDC estimates that there had been 83 million COVID cases at the end of the year in the US.  I think it is fair to assume that Texas had at least its pro rata share of those, so, say 8 million.  The confirmed infections have gone up by 50% since then end of the year so we must be closing in on about 12 million with some natural immunity by now.  That would be about 40% of the State’s population.  In addition, we have already fully vaccinated about 8% of the State and another 6% have had one shot.  So, about half of Texans now have some level of immunity.  That is almost certainly more than the herd immunity threshold for COVID, at least based on current behavior. Once the pandemic gets over the herd immunity threshold hump, Farr says the epidemic will decline at roughly the same rate it grew.  It sure looks like that is what we are seeing now.